The what, how and when of Presbyopia: the inability to focus

Normally, the lens in the eye changes shape to focus light directly onto the retina (back of the eye). But with age, the lens hardens and ciliary muscles of the eye weaken.Thus, near objects cannot be clearly focussed. This makes them look blurry.

What is 'Presbyopia'?

Presbyopia11 This condition is caused due to the eye's normal aging process in which a person is unable to focus on the near objects clearly due to the decrease in the elasticity of the normal lens. This loss of elasticity limits the ability of the eye to change its point of focus from distance to near. It starts at the age of about forty years.

What are the symptoms?

presbiopia-symptomPresbyopia makes it hard to do things close up, such as reading small print, using tools, or threading a needle. The first sign may be a tired feeling when you take a close look at something. Presbyopia most often starts when you a re forty to forty-five years old. It slowly progresses with age.

How is Presbyopia diagnosed?

Your eye doctor can tell you what your vision problem is by testing your vision. Glasses or contact lenses can then be prescribed to help you see better.

Why is eye examination necessary?

eye-examination-necessaryYour eye doctor measures the focusing power of your eyes' by using eye charts, lenses, and special instruments. This way, he or she can tell what magnifying power you will need for focusing on close objects. Your eye doctor can also tell what focusing power you'll need if you're nearsighted, farsighted, or astigmatic. He or she may also dilate your eyes to look inside them.
This is done to make sure nothing else is affecting your vision.

How is it treated?

Glasses

Presbyopia is most often corrected by wearing glasses. If you have no other vision problems, you may only need reading glasses. If you are also near-sighted or far-sighted, your eye doctor can prescribe bifocals, trifocals or progressive lenses. Reading glasses help you focus clearly on objects that are close. You can choose half glasses or full glasses.
Corrective lenses for treating Presbyopia bifocal-lensBifocals - Bifocals correct near and far vision ('bi' means 'two'). A small half–circle in the lower part of the lens magnifies objects that are close. In some cases, the whole lower half of the lens magnifies these objects.
trifocal-lensTrifocals - Trifocals correct near, middle and far vision (' tri'  means 'three'). The lower part of the lens has two magnifying powers. One magnifies near objects. The other magnifies objects that are about an arm's length away.
progressive-lensProgressive lenses - Progressive lenses change magnifying power from near to middle to far vision gradually. You do not notice a change from one power to the next. Moreover, you do not see any lines on the lenses.

Contact Lenses

There are two kinds of contact lenses that correct presbyopia. If you are presently wearing contact lenses, you can use reading glasses with the same. Mono-vision contact lenses correct one eye for close vision and one eye for far vision. This means one contact lens helps you read and see things that are near. The other contact lens helps you see things that are at a distance. Multi-focal contact lenses have magnifying power. Some alternate between near and far vision.Others gradually change from near to far vision. You do not notice a change from one power to the next. Talk with your eye doctor about which kind of multi-focal lens is best for you. Soflens ™ Multi Focal Lenses are aspheric multifocal lenses - they are "center-near" design and gradually change from correcting for near vision in the centre of the lenses to correcting for distance vision in the periphery. This transition provides patients with clear vision at all distances including intermediate vision.

Surgical Treatments available for Presbyopia :

  • Laser surgery for Presbyopia - Lasik & Custom LASIK
  • Refractive Lensectomy - PRELEX – Presbyopic Lens Exchange
  • Conductive Keratoplasty
Laser surgery for Presbyopia - Lasik & Custom LASIK Presbyopic LASIK: – Offers near normal vision Description - In Presbyopia, the nearest point that can be focused gradually recedes, leading to inability to read or undertake close work with the eye. Gradually patients also lose the ability to focus sharply in the middle distance. Presbyopic lasik is a procedure that allows the patient to focus on near objects while being able to focus on distant objects. Presbyopic Lasik modifies the curvature of the cornea creating a bilateral multifocal cornea in the treated optical zone. Suitability - Your ophthalmologist will conduct a detailed examination to determine your eligibility for Presbyopic lasik. The procedure is undertaken only when your eye doctor determines your eligibility. Patients who have undergone earlier eye surgery or those who have healing difficulties may not be recommended Presbyopic surgery. Benefits - Presbyopic Lasik has inherent advantages over Monofocal Lasik where one eye is corrected for near vision and the other is corrected for distant vision. It eliminates need for corrective lenses and offers near natural eye sight. Refractive Lensectomy - PRELEX – Presbyopic Lens Exchange ( Multi Focal Intra Ocular Lens) Description - This is an IOL (Intra-Ocular Lens) replacement procedure that replaces the natural lens with a multi-focal intra-ocular lens implant. Distinction - Traditional lens replacement were fixed-focus lenses. These would offer clear distance vision but required the use of reading glasses in most cases. Prelex offers the advantage of having a multifocal lense that reduces or eliminates the need for reading glasses. Suitability - The Prelex IOL implants are suitable for patients suffering from presbyopia. Benefit - Multi-focal lens sharply reduces or eliminates the need for reading glasses.
Conductive-KeratoplastyConductive Keratoplasty - CK is the first alternative to laser for treating farsightedness. The procedure is also currently being tested in clinical trials for the treatment of presbyopia, the age-related progressive form of farsightedness. While hyperopia and presbyopia both result in difficulty seeing near objects clearly, they have different causes and require different approaches for treatment.
For most farsighted patients, the CK procedure makes it possible to eliminate the need to wear reading glasses. The FDA has approved CK for the treatment of hyperopia between +0.75 and +3.25 diopters. CK is performed using a small probe, thinner than a strand of hair, that releases radiofrequency energy. The probe is applied in a circular pattern on the outer cornea (front window of the eye) to shrink small areas of corneal tissue. This circular pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea to treat farsightedness. The procedure, which takes about three minutes, is done in the doctor's office with only topical anesthesia (eye drops).

Regular Eye Examinations are a must

Eye exams are important to measure and correct vision problems. But seeing an eye doctor regularly also helps detect other eye problems. Early diagnosis and treatment of eye problems could save your eyesight.